Randolph County included in flu readiness study
By BILL RICHMOND
City editor
Randolph County is one of 13 counties recently evaluated by a Purdue University research team working to gauge Indiana's planning for the event of an outbreak of pandemic influenza.
The study found that panic, staffing issues, and geographic boundaries are some of the challenges that public health experts need to address as they create a comprehensive pandemic flu readiness plan.
"Most public health experts who are leading planning efforts for an influenza outbreak are focusing on specific geographic areas, usually counties, as defined by political lines, said George Avery, an assistant professor of health and kinesiology and a member of the Purdue Alternative Care Site Planning Team. "This is problematic because if there is an outbreak, planners need to take into account the people and health care systems that are or are not around them."
Avery said counties that border other states may experience nonresidents seeking treatment in their area. Other counties may be home to the only isolated hospital system in the region and can expect the population from other states to travel there for care. Health care, especially in a crisis, he said is not defined by county or state lines.
"Instead of each Indiana county health department making plans for its individual county, plans should be developed, or at least coordinated regionally," he said.
Members of the Purdue Alternative Care Site Planning Team interviewed public health planners in 13 of Indiana's 92 counties from Nov. 2006 to Aug. 2007. Counties included in the study are: Allen, Clay, Dearborn, Fulton, Huntington, Lake, Johnson, Montgomery, Orange, Posey, Randolph, Sullivan and Warrick. Purdue's Healthcare Technical Assistance Program assembled the team to look at issues about planning for alternative care sites and other surge capacity issues during a pandemic - such as staffing concerns, medication supplies, medical equipment access and healthcare system and insurance limits.
Influenza hospitalizes 200,000 Americans annually and kills 36,000. In 2005, global concern was raised about a possible influenza pandemic because the number of human deaths related to bird flu was increasing in some Asian countries. There is concern that if the virus were transmitted human to human, a global outbreak could result in millions of deaths. As a result, federal, state and local leaders continue to develop plans.
"Another significant planning concern is related to staffing, especially at alternate care sites," said Mark Lawley, an associate professor of biomedical engineering specializing in healthcare delivery systems who is part of the research team. "During a pandemic, we can expect that caregivers will become ill, some caregivers will be reluctant to work and others will stay home to care for their own family members. Many planners are suggesting alternate care sites during an outbreak, but finding additional staff members for these units will be a big impediment."
Lawley said the strain on the workforce will likely affect the overall standard of care.
"The public has expectations about the standard of health care," he said. "For example, doctors prescribe medications and nurses administer them, but what happens if one group is understaffed during a crisis? How are roles to be reassigned and how will that be communicated to patients?"
In addition to staffing and community coordination issues, the researchers also found that misunderstandings about projected mortality and illness rates are creating panic. To counter this, researchers suggested more explanations by federal, state, international and academic experts about statistics and surveillance.
The research team also observed some contradictions in planning efforts. Counties planned on limited resources and expected to compete among themselves for basic medical supplies and other necessities. The plans also acknowledged assistance would be sought from external groups, such as the National Guard or governor's office.
